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Gross Anatomy of the Kidney ∗

OpenStax College
This work is produced by OpenStax-CNX and licensed under the
Creative Commons Attribution License 3.0†

Abstract
By the end of this section, you will be able to:
• Describe the external structure of the kidney, including its location, support structures, and covering
• Identify the major internal divisions and structures of the kidney
• Identify the major blood vessels associated with the kidney and trace the path of blood through
the kidney
• Compare and contrast the cortical and juxtamedullary nephrons
• Name structures found in the cortex and medulla
• Describe the physiological characteristics of the cortex and medulla
The kidneys lie on either side of the spine in the retroperitoneal space between the parietal peritoneum
and the posterior abdominal wall, well protected by muscle, fat, and ribs. They are roughly the size of your
st, and the male kidney is typically a bit larger than the female kidney. The kidneys are well vascularized,
receiving about 25 percent of the cardiac output at rest.

: There have never been sucient kidney donations to provide a

1
kidney to each person needing one. Watch this video to learn about the TED (Technology, En-
tertainment, Design) Conference held in March 2011. In this video, Dr. Anthony Atala discusses a
cutting-edge technique in which a new kidney is printed. The successful utilization of this tech-
nology is still several years in the future, but imagine a time when you can print a replacement
organ or tissue on demand.

∗ Version 1.3: Jun 19, 2013 3:26 pm -0500

† http://creativecommons.org/licenses/by/3.0/
1 http://openstaxcollege.org/l/TED

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1 External Anatomy
The left kidney is located at about the T12 to L3 vertebrae, whereas the right is lower due to slight displace-
ment by the liver. Upper portions of the kidneys are somewhat protected by the eleventh and twelfth ribs
(Figure 1 (Kidneys )). Each kidney weighs about 125175 g in males and 115155 g in females. They are
about 1114 cm in length, 6 cm wide, and 4 cm thick, and are directly covered by a brous capsule composed
of dense, irregular connective tissue that helps to hold their shape and protect them. This capsule is covered
by a shock-absorbing layer of adipose tissue called the renal fat pad, which in turn is encompassed by a
tough renal fascia. The fascia and, to a lesser extent, the overlying peritoneum serve to rmly anchor the
kidneys to the posterior abdominal wall in a retroperitoneal position.

Kidneys

Figure 1: The kidneys are slightly protected by the ribs and are surrounded by fat for protection (not
shown).

On the superior aspect of each kidney is the adrenal gland. The adrenal cortex directly inuences renal
function through the production of the hormone aldosterone to stimulate sodium reabsorption.

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2 Internal Anatomy
A frontal section through the kidney reveals an outer region called the renal cortex and an inner region
called the medulla (Figure 2 (Left Kidney )). The renal columns are connective tissue extensions that
radiate downward from the cortex through the medulla to separate the most characteristic features of the
medulla, the renal pyramids and renal papillae. The papillae are bundles of collecting ducts that
transport urine made by nephrons to the calyces of the kidney for excretion. The renal columns also serve
to divide the kidney into 68 lobes and provide a supportive framework for vessels that enter and exit the
cortex. The pyramids and renal columns taken together constitute the kidney lobes.

Left Kidney

Figure 2

3 Renal Hilum
The renal hilum is the entry and exit site for structures servicing the kidneys: vessels, nerves, lymphatics,
and ureters. The medial-facing hila are tucked into the sweeping convex outline of the cortex. Emerging from
the hilum is the renal pelvis, which is formed from the major and minor calyxes in the kidney. The smooth
muscle in the renal pelvis funnels urine via peristalsis into the ureter. The renal arteries form directly from
the descending aorta, whereas the renal veins return cleansed blood directly to the inferior vena cava. The
artery, vein, and renal pelvis are arranged in an anterior-to-posterior order.

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3.1 Nephrons and Vessels

The renal artery rst divides into segmental arteries, followed by further branching to form interlobar arteries
that pass through the renal columns to reach the cortex (Figure 3 (Blood Flow in the Kidney )). The
interlobar arteries, in turn, branch into arcuate arteries, cortical radiate arteries, and then into aerent
arterioles. The aerent arterioles service about 1.3 million nephrons in each kidney.

Blood Flow in the Kidney

Figure 3

Nephrons are the functional units of the kidney; they cleanse the blood and balance the constituents
of the circulation. The aerent arterioles form a tuft of high-pressure capillaries about 200 µm in diameter,
the glomerulus. The rest of the nephron consists of a continuous sophisticated tubule whose proximal
end surrounds the glomerulus in an intimate embracethis is Bowman's capsule. The glomerulus and
Bowman's capsule together form the renal corpuscle. As mentioned earlier, these glomerular capillaries
lter the blood based on particle size. After passing through the renal corpuscle, the capillaries form a
second arteriole, the eerent arteriole (Figure 4 (Blood Flow in the Nephron )). These will next form

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a capillary network around the more distal portions of the nephron tubule, the peritubular capillaries
and vasa recta, before returning to the venous system. As the glomerular ltrate progresses through the
nephron, these capillary networks recover most of the solutes and water, and return them to the circulation.
Since a capillary bed (the glomerulus) drains into a vessel that in turn forms a second capillary bed, the
denition of a portal system is met. This is the only portal system in which an arteriole is found between
the rst and second capillary beds. (Portal systems also link the hypothalamus to the anterior pituitary,
and the blood vessels of the digestive viscera to the liver.)

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Blood Flow in the Nephron

Figure 4: The two capillary beds are clearly shown in this gure. The eerent arteriole is the connecting
vessel between the glomerulus and the peritubular capillaries and vasa recta.

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2
: Visit this link to view an interactive tutorial of the ow of blood
through the kidney.

3.2 Cortex
In a dissected kidney, it is easy to identify the cortex; it appears lighter in color compared to the rest of the
proximal convoluted tubules (PCTs) and distal
kidney. All of the renal corpuscles as well as both the
convoluted tubules are found here. loop of Henle that does not dip beyond
Some nephrons have a short
the cortex. These nephrons are called cortical nephrons. About 15 percent of nephrons have long loops
of Henle that extend deep into the medulla and are called juxtamedullary nephrons.

4 Chapter Review
As noted previously, the structure of the kidney is divided into two principle regionsthe peripheral rim
of cortex and the central medulla. The two kidneys receive about 25 percent of cardiac output. They are
protected in the retroperitoneal space by the renal fat pad and overlying ribs and muscle. Ureters, blood
vessels, lymph vessels, and nerves enter and leave at the renal hilum. The renal arteries arise directly from
the aorta, and the renal veins drain directly into the inferior vena cava. Kidney function is derived from
the actions of about 1.3 million nephrons per kidney; these are the functional units. A capillary bed,
the glomerulus, lters blood and the ltrate is captured by Bowman's capsule. A portal system is formed
when the blood ows through a second capillary bed surrounding the proximal and distal convoluted tubules
and the loop of Henle. Most water and solutes are recovered by this second capillary bed. This ltrate is
processed and nally gathered by collecting ducts that drain into the minor calyces, which merge to form
major calyces; the ltrate then proceeds to the renal pelvis and nally the ureters.

5 Review Questions
Exercise 1 (Solution on p. 9.)
The renal pyramids are separated from each other by extensions of the renal cortex called ________.

a. renal medulla
b. minor calyces
c. medullary cortices
d. renal columns

Exercise 2 (Solution on p. 9.)

The primary structure found within the medulla is the ________.

a. loop of Henle
b. minor calyces

2 http://openstaxcollege.org/l/bloodow5

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c. portal system
d. ureter

Exercise 3 (Solution on p. 9.)

The right kidney is slightly lower because ________.

a. it is displaced by the liver

b. it is displace by the heart
c. it is slightly smaller
d. it needs protection of the lower ribs

6 Critical Thinking Questions

Exercise 4 (Solution on p. 9.)
What anatomical structures provide protection to the kidney?

Exercise 5 (Solution on p. 9.)

How does the renal portal system dier from the hypothalamohypophyseal and digestive portal
systems?

Exercise 6 (Solution on p. 9.)

Name the structures found in the renal hilum.

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Solutions to Exercises in this Module

to Exercise (p. 7)
D
to Exercise (p. 7)
A
to Exercise (p. 8)
A
to Exercise (p. 8)
Retroperitoneal anchoring, renal fat pads, and ribs provide protection to the kidney.
to Exercise (p. 8)
The renal portal system has an artery between the rst and second capillary bed. The others have a vein.
to Exercise (p. 8)
The structures found in the renal hilum are arteries, veins, ureters, lymphatics, and nerves.

Glossary
Denition 1: Bowman's capsule
cup-shaped sack lined by a simple squamous epithelium (parietal surface) and specialized cells
called podocytes (visceral surface) that participate in the ltration process; receives the ltrate
which then passes on to the PCTs

Denition 2: calyces
cup-like structures receiving urine from the collecting ducts where it passes on to the renal pelvis
and ureter

Denition 3: cortical nephrons

nephrons with loops of Henle that do not extend into the renal medulla

Denition 4: distal convoluted tubules

portions of the nephron distal to the loop of Henle that receive hyposmotic ltrate from the loop
of Henle and empty into collecting ducts

Denition 5: eerent arteriole

arteriole carrying blood from the glomerulus to the capillary beds around the convoluted tubules
and loop of Henle; portion of the portal system

Denition 6: glomerulus
tuft of capillaries surrounded by Bowman's capsule; lters the blood based on size

Denition 7: juxtamedullary nephrons

nephrons adjacent to the border of the cortex and medulla with loops of Henle that extend into the
renal medulla

Denition 8: loop of Henle

descending and ascending portions between the proximal and distal convoluted tubules; those of
cortical nephrons do not extend into the medulla, whereas those of juxtamedullary nephrons do
extend into the medulla

Denition 9: nephrons
functional units of the kidney that carry out all ltration and modication to produce urine; consist
of renal corpuscles, proximal and distal convoluted tubules, and descending and ascending loops of
Henle; drain into collecting ducts

Denition 10: medulla

inner region of kidney containing the renal pyramids

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Denition 11: peritubular capillaries

second capillary bed of the renal portal system; surround the proximal and distal convoluted tubules;
associated with the vasa recta

Denition 12: proximal convoluted tubules (PCTs)

tortuous tubules receiving ltrate from Bowman's capsule; most active part of the nephron in
reabsorption and secretion

Denition 13: renal columns

extensions of the renal cortex into the renal medulla; separates the renal pyramids; contains blood
vessels and connective tissues

Denition 14: renal corpuscle

consists of the glomerulus and Bowman's capsule

Denition 15: renal cortex

outer part of kidney containing all of the nephrons; some nephrons have loops of Henle extending
into the medulla

Denition 16: renal fat pad

adipose tissue between the renal fascia and the renal capsule that provides protective cushioning
to the kidney

Denition 17: renal hilum

recessed medial area of the kidney through which the renal artery, renal vein, ureters, lymphatics,
and nerves pass

Denition 18: renal papillae

medullary area of the renal pyramids where collecting ducts empty urine into the minor calyces

Denition 19: renal pyramids

six to eight cone-shaped tissues in the medulla of the kidney containing collecting ducts and the
loops of Henle of juxtamedullary nephrons

Denition 20: vasa recta

branches of the eerent arterioles that parallel the course of the loops of Henle and are continuous
with the peritubular capillaries; with the glomerulus, form a portal system

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